Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $12.02 / $16.22	Facility	26	$8.71	$12.02	$16.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $67.61 / $218.78	Professional		$51.29	$67.61	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.47 / $33.11	Professional	26	$7.94	$10.47	$33.11
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $8.13 / $8.32 / $39.81	Professional	52	$8.13	$8.32	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $52.48 / $112.20	Professional	TC	$42.66	$52.48	$112.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $52.48 / $74.13	Professional		$45.71	$52.48	$74.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.33 / $12.02	Professional	26	$7.59	$9.33	$12.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $46.77 / $46.77	Professional	TC	$46.77	$46.77	$46.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $47.86 / $95.50	Professional		$9.77	$47.86	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $75.86 / $117.49	Professional		$53.70	$75.86	$117.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.02 / $19.05	Professional	26	$8.91	$12.02	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $63.10 / $100.00	Professional	TC	$45.71	$63.10	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $112.20 / $323.59	Professional		$54.95	$112.20	$323.59
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $16.60 / $93.33	Professional	26	$8.91	$16.60	$93.33
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $75.86 / $275.42	Professional	TC	$44.67	$75.86	$275.42
Hally Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $67.61 / $72.44	Professional		$66.07	$67.61	$72.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $10.96 / $11.48	Professional	26	$10.47	$10.96	$11.48
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $56.23 / $61.66	Professional	TC	$54.95	$56.23	$61.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $67.61 / $104.71	Professional		$50.12	$67.61	$104.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.72 / $16.98	Professional	26	$7.94	$10.72	$16.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $56.23 / $89.13	Professional	TC	$41.69	$56.23	$89.13